Maple Counseling

If you are interested in receiving counseling services, please call the Briskin|Wilder Welcome Center at 310-271-9999 and our Care Associate will assist you.

INSTRUCTIONS ONCE YOU HAVE SPOKEN TO A CARE ASSOCIATE

PAYMENT

In order to proceed with your intake appointment, Maple Counseling kindly requests payment of the non-refundable $35.00 intake fee. You can complete this payment by clicking the link below when instructed by our Care Associate.

Form

There are 2 different options to submit the Intake Form

1. Download this PDF Family/Child Intake Form and email the completed form to adintake@tmcc.org.
2. Once confirmed, complete the form through DocuSign here. Once completed you will receive a copy of the completed form.

All intake forms must be submitted the day before your intake appointment.

This ensures your therapist will be able to familiarize him/herself with this important information before your intake appointment. Thank you for your cooperation.